My Father’s Brain

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PERSONAL HISTORY about the writer’s father and Alzheimer’s Disease… Writer looks over the autopsy report for his father’s brain, which came along with a Valentine from his mother… Some years before he died, my father had participated in a study of memory and aging at Washington University, and one of the perks for participants was a post-mortem brain autopsy, free of charge. I suspect that the study offered other perks of monitoring and treatment which had led my mother, who loved freebies of all kinds, to insist that my father volunteer for it. Thrift was also probably her only conscious motive for including the autopsy report in my Valentine’s package. She was saving thirty-two cents’ postage… According to the latest theories, which are based on a wealth of neurological and psychological research in the last few decades, the brain is not an album in which memories are stored discretely like unchanging photographs. Instead, a memory is, in the phrase of the psychologist Daniel L. Schacter, a "temporary constellation" of activity-a necessarily approximate excitation of neural circuits that bind a set of sensory images and semantic data into the momentary sensation of a remembered whole… The human brain is a web of a hundred billion neurons, maybe as many as two hundred billion, with trillions of axons and dendrites exchanging quadrillions of messages by way of at least fifty different chemical transmitters. The organ with which we observe and make sense of the universe is, by a comfortable margin, the most complex object we know of in that universe. And yet it’s also a lump of meat… Alzheimer’s is a disease of classically "insidious onset." Since even healthy people become more forgetful as they age, there’s no way to pinpoint the first memory to fall victim to it… Writer tells about staying with his father for five weeks while his mother was in the hospital… Senile dementia has been around for as long as people have had the means of recording it. While the average human life span remained low and old age was a comparative rarity, senility was considered a natural by-product of aging-perhaps the result of sclerotic cerebral arteries. The German neuropathologist Alois Alzheimer believed he was witnessing an entirely new variety of mental illness when, in 1901, he admitted to his clinic a fifty-one-year-old woman, Auguste D., who was suffering from bizarre mood swings and severe memory loss and who, in Alzheimer’s initial examination of her, gave problematic answers to his questions… . But because the science of the disease remains cloudy (a functioning brain is not a lot more accessible than the center of the earth or the edge of the universe) nobody can be sure which avenues of research will lead to effective treatments. Early-onset Alzheimer’s is usually linked to specific genes, but the vastly more common late-onset variety cannot be traced to a single factor… On the immunological front, researchers at Elan Pharmaceuticals recently came up with the seemingly outlandish idea of a vaccine for Alzheimer’s-of teaching the immune system to produce antibodies that attack and destroy amyloid plaques in the brain-and found that the vaccine not only prevented plaque formation in transgenic mice but actually reversed the mental deterioration of mice already addled by it. Over all, the feeling in the field seems to be that if you’re under fifty you can reasonably expect to be offered effective drugs for Alzheimer’s by the time you need them. Tells about his father’s hospitalization and death… One of the stories I’ve come to tell, then, as I try to forgive myself for my long blindness to his condition, is that he was bent on concealing that condition and, for a remarkably long time, retained the strength of character to bring it off… Tells about a short letter to a grandson they found… Tells how he stopped eating and eventually stopped breathing…